Schädigungs- und Reparaturmechanismen in Multiple-Sklerose-Läsionen

T. Kuhlmann

doi:10.1055/s-0038-1628689

Nervenheilkunde, Table of Contents

Nervenheilkunde 2009; 28(09): 593-601
DOI: 10.1055/s-0038-1628689

Neuropathologie

Schattauer GmbH

Schädigungs- und Reparaturmechanismen in Multiple-Sklerose-Läsionen

Damage and reparation mechanisms in multiple sclerosis lesions

T. Kuhlmann

¹Institut für Neuropathologie, Universitätsklinikum Münster

› Author Affiliations

Abstract

Zusammenfassung

Dieser Artikel gibt einen Überblick über die histologischen Charakteristika der Multiplen Sklerose (MS) und die pathogenetischen Konzepte bezüglich der Entstehung der Entzündung, des axonalen Schadens und der Remyelinisierung.

Die MS ist die häufigste entzündlich demyelinisierende Erkrankung des zentralen Nervensystems. Es handelt sich um eine komplexe Erkrankung, deren progrediente Erkrankungsphase medikamentös nicht signifikant beeinflusst werden kann. Histologisch ist diese Erkrankung durch fokal entzündliche, demyelinisierte Läsionen sowie eine diffuse Pathologie in der normal erscheinenden weißen Substanz charakterisiert. Der zum Teil ausgeprägte axonale Schaden und Verlust ist nicht nur in den Läsionen, sondern auch in der normal erscheinenden weißen Substanz nachweisbar. Die Remyelinisierung ist in der Mehrheit der chronischen MS-Läsionen limitiert. Voraussetzung für die Entwicklung Erfolg versprechender neuroprotektiver Therapien ist die Identifizierung der exakten Mechanismen, die zur Demyelinisierung und zum axonalen Verlust in MS-Läsionen führen.

Summary

This article provides an overview about the histopathological hallmarks of multiple sclerosis (MS) and the current pathogenetic concepts regarding inflammation, axonal damage and remyelination.

MS is the most frequent demyelinating disease of the central nervous system. It is a complex disease and no treatment options are available to significantly influence this progressive disease phase. Histopathologically, MS is characterized by focal inflammatory, demyelinating MS lesions and diffuse white matter pathology. Partially extensive axonal damage and loss is detectable in focal lesions and in the normal appearing white matter. Remyelination is limited in the majority of chronic MS lesions. Prerequisite for the development of neuroprotective treatment strategies is the identification of the exact mechanisms leading to demyelination and axonal loss in MS lesions.

Schlüsselwörter

Multiple Sklerose - axonaler Schaden - Remyelinisierung - progrediente MS

Keywords

Multiple sclerosis - axonal damage - remyelination - progressive MS

Full Text

References

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